Behavioral Strategies to Address Healthcare Overutilization: A South Korean Policy Proposal for Delayed Reimbursement

Abstract

The South Korean healthcare system faces significant challenges, including high service utilization, unnecessary consultations, and escalating healthcare expenditures, which strain the National Health Insurance (NHI). This perspective proposes a delayed reimbursement model to mitigate the overconsumption of healthcare services. Under this model, patients prepay for medical services, and the NHI reimburses a proportion of the cost after a designated period. This approach leverages behavioral economics principles, such as the “pain of paying,” which posits that upfront payments can deter unnecessary medical usage.

The delayed reimbursement model aims to reduce frivolous medical spending by imposing immediate out-of-pocket costs on patients. The phased implementation will initially focus on non-urgent and potentially overutilized services, ensuring that essential or high-priority medical care remains unaffected. By addressing behavioral factors contributing to overutilization and incorporating socioeconomic status considerations, this model promotes the NHI's financial stability while maintaining equitable access to healthcare.